Cost Analysis of Current Distribution and Redesigned Distribution Systems for Vaccines in Rwanda

Background Immunization supply chain management is among the components of immunization program, making vaccines delivery possible to reach every child. Nevertheless, it has been found to be static with rapid changes linked to the introduction of new vaccines. The success of Rwanda immunization program with coverage of 94.3% was attributed to human resource and capital investment from both the Ministry of Health and its development partners. However, the current distribution system design does not contribute to self-financing of the program in the long-run considering the distribution mode and frequency applied. The cost analysis study has never been done before and is expected to address the issue of long-term sustainability of the program as it will inform the system re-design activities.   Objective Assessing how much the program would save if the system is re-designed by changing distribution mode and frequency from the Central Vaccine Store to District Vaccine Stores. Methods Administrative and financial records were reviewed to determine the cost of the current vaccine distribution system to be compared to estimated cost of a proposed distribution system with reduced frequencies between Central Vaccine Store and District Vaccine Stores. Results By comparing the costs of the two systems, applying the proposed distribution model with less distribution frequencies reduced the current cost by 37%. Conclusion The findings confirm a huge opportunity of getting the current vaccine distribution costs reduced when the distribution system is redesigned, hence contributing to financial sustainability of the vaccination program. Rwanda J Med Health Sci 2021;4(2): 207-22

PENDEKATAN SERVICE LEARNING DALAM PEMBELAJARAN PENDIDIKAN KEWARGANEGARAAN DI UNIVERSITAS PELITA HARAPAN ERA NEW NORMAL

ABSTRACTThe Service Learning approach is one of the methods in the learning process for Civics Education courses at Pelita Harapan University, responding to challenges as general, boring, and monotonous teaching methods. The motto of Service Learning at UPH is “100 percent serve and 100 percent learn”.This approach aims to be able to form the personality of the younger generation who are able to manage emotions, can work in a work team, and have an honorable identity. In addition, it has invited the community to take an active role in the world of education. All these processes can be done via virtual. Through reciprocal and routine communication between students, lecturers, partners, and online services are able to turn on a new atmosphere in the learning process during the learn of home period. In the new normal era, the Service Learning approach is very helpful in increasing the enthusiasm for student learning due to drastic changes in the way of life that must only learn from home via virtually. Students are very enthusiastic about their work and feel proud because they can help the community during the covid 19 pandemic. Service Learning activities are actualized in the form of videos and make self-reflection. Through self-reflection, students express their joy and pride about what they are doing in the new normal.Keywords: The Service Learning approach, Video, Self ReflectionAbstrakPendekatan Service Learning menjadi salah satu metode dalam proses pembelajaran  mata kuliah Pendidikan Kewarganegaraan di Universitas Pelita Harapan, menjawab tantangan sebagai mata kuliah umum, membosankan, dan metode mengajar yang monoton. Moto Service Learning di UPH adalah “100 persen serve dan 100 persen learn”.  Pendekatan ini bertujuan membentuk pribadi generasi muda yang mampu menyelesaikan masalah, menata emosi, bisa bekerja dalam sebuah tim kerja, dan memiliki kehormatan identitas.  Selain itu mengajak masyarakat ikut serta berperan aktif dalam dunia pendidikan. Mahasiswa aktif bekerja dalam kelompok, meskipun berbentuk virtual. Melalui komunikasi timbal balik dan rutin antar mahasiswa, mahasiswa dengan dosen dan mitra, serta mencari jasa layanan online seperti penjualan online dan serta grab atau gojek mampu menghidupkan suasana baru dalam proses pembelajaran di masa  “learn of home”. Di era new normal, pendekatan Service Learning sangat membantu menambah semangat belajar mahasiswa akibat perubahan drastis cara hidup yang harus belajar dari rumah secara “virtual” saja. Melalui projek Service Learning, mahasiswa sangat antusias berkarya dan merasa bangga karena dapat membantu masyarakat di masa pandemi covid 19. Kegiatan Service Learning diaktualkan dalam bentuk video dan membuat refleksi diri. Melalui refleksi diri, mahasiswa menuangkan kegembiraan dan kebanggaan tentang apa yang dilakukan di masa new normal.Kata Kunci : pendekatan, service learning, video, refleks

THE ROLES AND POLICIES FOR THE USE OF TELEMEDICINE IN HANDLING COVID-19 SELF-ISOLATION: LITERATURE REVIEW

The current COVID-19 pandemic has had various impacts on the world. The unpredictable spike in cases led to an explosion in patient numbers. The problem of limited treatment facilities forces patients to self-isolate at home. Along with technological advances, various facilities have also been created, one of which is telemedicine. This study aims to look at the role of telemedicine as a strategy for handling COVID-19 self-isolated patients in various countries. This study was conducted descriptively with a literature review. The search was carried out on articles published in Indonesian and English through Google Scholar, Pubmed, and Science Direct searches with the keywords COVID-19, home isolation, self-isolation, telemedicine, and telehealth. The search results obtained that the handling of COVID-19 patients in self-isolation with telemedicine is a solution to the need for monitoring patient health, where hospitals have difficulty being able to serve all patients who need hospitalization. It can be concluded that COVID-19 is a newly emerging disease, clinical symptoms and emergencies of each patient can certainly be different and difficult to predict. Telemedicine as a remote health service can be a means to facilitate clinical monitoring of patients during self-isolation. The implementation of telemedicine ensures the continuity of health services quite effectively and efficiently, the way telemedicine works helps protect patients and health workers from exposure to infection and reduces the burden on hospitals, so it is quite appropriate to be used as a strategy in handling if there is a spike in COVID-19 cases in the future or application to other similar circumstances

Model for acoustic induced aluminum combustion fluctuations in solid rocket motors

Combustion of aluminum droplets released by the solid propellant is widely used to increase the thrust in solid rocket motors. The combustion dynamics of the released droplet cloud in the unsteady flow is however susceptible to trigger thermoacoustic instabilities. A theoretical analysis is conducted to determine the heat release rate fluctuations produced by the burning droplet cloud for small acoustic disturbances. Two contributions to heat release fluctuations are identified. The first originates from fluctuations of the evaporation rate due to the oscillating flow around the droplets. This leads to local fluctuations of the volumetric rate of heat release within the droplet cloud. The second one originates from the motion of the boundary of the burning droplet cloud at the end of the combustion process. This motion is due to droplet lifetime oscillations leading to an additional source of heat release disturbances. Both contributions to heat release disturbances take place within the acoustic boundary layer along the solid propellant surface. Quasi-steady models for the response of the droplet diameter fluctuations and droplet velocity fluctuations are derived. Combined with a model for the gas velocity fluctuations within the acoustic boundary layer they lead to expressions for the resulting heat release rate disturbances within the droplet cloud and at its boundary. Results are compared to a previous low order model and to numerical flow simulations. It is shown that the new model leads to close agreement with simulations over the entire flow. The derived expressions yield a better understanding on heat release disturbances and can be used to predict the linear stability of a solid rocket motor at reduced computational costs

IMPACT OF SOCIO-ECONOMIC FACTOR ON CHILD DEVELOPMENT AMONG URBAN POOR - A STUDY IN BANGALORE, INDIA

The study has been undertaken to document the nutritional status of school going children among Bangalore’s Urban Poor and to document the factors influencing it. The three anthropometric measures namely wasting, stunting and underweight is used to understand the level of malnutrition in children. The main focus of the study is to document the nutrition status of children from poor urban households through the anthropometric measures, to analyse the socio economic factors like gender and income and their impact on nutritional status. The data was collected from a sample of households drawn from Bangalore’s slums and was drawn using cluster sampling. Moderate levels of stunting is seen in majority of households and also across both gender, slightly higher with the female children and it was found predominant in small and large families across all categories of caste. The Gomez index measuring nutrition based on weight for age found small percentage of children with mild form of malnutrition across income and gender groups. Gomez analysis also found that with increase in family size the level of malnutrition, which is strengthened through the logistic regression. Wasting was also found at moderate levels in more than fifty percent of the households. logistic regression was used to analyse the factors influencing economic development revealed that the age of the child and family size were deterrent factors affect nutrition levels

Multiparidad como factor de riesgo asociado a retención placentaria en gestantes del Hospital Belén de Trujillo

Objetivo: Determinar si la multiparidad es factor de riesgo asociado a retención placentaria en gestantes del Hospital Belén de Trujillo. Material y Métodos: Se llevó a cabo un estudio de tipo analítico, observacional, retrospectivo, de casos y controles. La población de estudio estuvo constituida por 136 gestantes; las cuales fueron divididas en 2 grupos: con retención placentaria o sin ella; se calculó el odds ratio y la prueba chi cuadrado. Resultados: No se apreciaron diferencias significativas en relación con las variables edad materna, edad gestacional y procedencia entre los pacientes con retención placentaria o sin ella. La frecuencia de multiparidad en gestantes con retención placentaria fue de 18/68= 26%. La frecuencia de multiparidad en gestantes sin retención placentaria fue de 8/68= 13%. La multiparidad es factor de riesgo para retención placentaria en gestantes con un odds ratio de 2.7 el cual fue significativo (p<0.05). Conclusiones: La multiparidad es factor de riesgo asociado a retención placentaria en gestantes del Hospital Belén de Trujillo.Objective: To determine if multiparity is a risk factor associated with placental retention in pregnant women of the Belén Hospital of Trujillo. Material and Methods: An analytical, observational, retrospective, case and control study was carried out. The study population consisted of 136 pregnant women; which were divided into 2 groups: with or without placental retention; the odds ratio and the chi square test were calculated. Results: No significant differences were observed in relation to the variables of maternal age, gestational age and origin among patients with or without retained placental. The frequency of multiparity in pregnant women with placental retention was 18/68 = 26%. The frequency of multiparity in pregnant women without placental retention was 8/68 = 13%. Multiparity is a risk factor for placental retention in pregnant women with an odds ratio of 2.7 which was significant (p <0.05). Conclusions: Multiparity is a risk factor associated with placental retention in pregnant women at the Belén Hospital of Trujillo.Tesi

Sistem Rekomendasi Pemilihan Saham dengan Objektivitas Fundamental Kuantitatif Menggunakan Metode Topsis Berbasis Web

Saham merupakan salah satu instrumen keuangan yang dapat memberikan keuntungan cukup besar. Akan tetapi, berinvestasi saham tidak semudah yang dibayangkan, dengan pendapatan yang tinggi saham juga memliki resiko tinggi sehingga dapat menimbulkan kerugian apabila investor tidak cermat dalam menganalisa emiten atau perusahaan untuk berinvestasi. Pada penelitian ini, pengembang membangun sebuah aplikasi berbasis web untuk membandingkan emiten yang terdaftar dalam industri pasar modal di Bursa Efek Indonesia dengan objektivitas fundamental kuantitatif menggunakan metode MCDM (Multi-Criteria Decision Making) - TOPSIS (Technique of Order Preference by Similarity to Ideal Solution). Pengujian aplikasi menggunakan Skala Likert dengan implementasi DeLone and McLean evaluation model yang menetapkan enam buah aspek kesuksesan sebuah sistem. Hasil evaluasi menunjukkan bahwa aplikasi Rekomendasi Pemilihan Saham bermanfaat untuk membantu dalam memilih saham terbaik untuk berinvestasi dengan persentase sebesar 87.5%

FORMULASI DAN UJI EFEKTIFITAS SEDIAAN GEL EKSTRA ETANOL DAUN MANGROVE API-API (AVICENNIA MARINA) SEBAGAI ANTISEPTIK TANGAN

Avicennia marina is a plant, that have anti-inflammation activity, antioxidant, antibacterial, andantivirus. Based on the compound owned, fire Mangrove (Avicennia marina) can be used as antiseptic hand. Purpose from this research is to formulate and test effect of hand antiseptic gel. Leaf extract gel stocks formulation fire Mangrove (Avicennia marina) has made with various concentration of extract that is 10%, 15%, and 20% with CMC-Na as it base. Use CMC-Na for the negative control and for positive control used Detol® Hand Sanitizer. For physical gel result include : organoleptic, homogenity and pH.  Antiseptic gel testing was used replica method and testing data were analyzed by One Way Anova. The results of this research showed that leaf extract gel from fire Mangrove full fil the organoleptic quality parameters gel, homogeneity, pH and no have effect as hand antiseptic.   Key words : leaf extract etanol gel from Mangrove Api-api (Avicennia marina), antiseptics, replica metho

Rancang Bangun Front-end Aplikasi NGERTI IT Berbasis Mobile Dengan Menggunakan Framework Flutter

Laporan ini memaparkan tentang pembuatan aplikasi Ngerti IT yang merupakan aplikasi pembelajaran berbasis mobile untuk end user yang dikembangkan oleh PT. Pollaris Cahaya Bangsa dengan tujuan mengedukasi pengguna aplikasi untuk lebih memahami dunia teknologi informasi. Aplikasi ini dibuat dengan tujuan sebagai sarana pembelajaran mengenai teknologi informasi baik software maupun hardware. Dalam pembuatannya, digunakan bahasa pemrograman Dart dan framework Flutter. Device dari aplikasi merupakan platform Android maupun iOS karena ini merupakan aplikasi mobile cross-platform. Aplikasi ini sudah rampung dengan beberapa fitur utama seperti fitur solusi, life-hack, kamus yang merupakan konten dan juga setting aplikasi serta fitur forum yang sudah berjalan dengan baik. Bagian yang belum rampung dari aplikasi Ngerti IT adalah fitur history